Physiologic markers of chronic stress in premenopausal,middle-aged women

OBJECTIVE: The purpose of this study was to identify physiological markers of chronic stress in middle-aged women that can be assessed simply and are thus feasible for introduction into large-scale, epidemiologic studies of aging. METHODS: Subjects were 40 nonsmoking, premenopausal women between the ages of 42 and 52 years, 20 of whom were chronically stressed because of undergoing a divorce or separation and 20 of whom were nonstressed because of being in stable marriages. Stressed and nonstressed women were matched for age, ethnicity, and education. Hypotheses focused on morning and evening salivary cortisol, overnight urinary catecholamines, cortisol, and testosterone, and platelet catecholamines. RESULTS: Relative to the nonstressed control subjects, the stressed women had elevated evening (9 PM) salivary cortisols, a finding that was observed on both days (mixed effects model: effect = 0.44; se = 0.14, p =.003). Support for the importance of the HPA axis was provided by the observation that the stressed women had less suppression of salivary cortisol in response to low-dose dexamethasone. Contrary to our hypothesis that stressed women would have lower overnight urinary testosterone, they had higher testosterone on day 2 (stressed = 0.76 ng/mg, nonstressed = 0.55 ng/mg; p =.04). Post hoc repeated measures analysis revealed a significant group effect over all time periods of observation (F = 5.48, p =.03, df = 1,18). Stressed women had a nonsignificant trend toward elevated platelet catecholamines. No association was found for overnight urinary catecholamines or cortisol. CONCLUSIONS: Promising markers of marital upheaval in middle-aged women are evening salivary cortisol and urinary testosterone from a first morning void. Replication of these findings with the same and different chronic stressors and with women of older ages is needed. The low cost and minimal burden of these potential markers makes it feasible to introduce them into large-scale epidemiologic studies of health in aging women.     

Circadian variation in salivary testosterone across age classes in Ache Amerindian males of Paraguay

Testosterone levels exhibit a circadian rhythm in healthy men, with morning levels tending to be higher compared to evening titers. However, circadian rhythms wane with age. Although this has been described in males living within industrialized settings, age‐related changes have not received similar attention in populations outside these contexts. Because many nonindustrialized populations, such as Ache Amerindians of Paraguay, exhibit testosterone levels that are lower than what is commonly reported in the clinical literature and lack age‐associated variation in testosterone, it was hypothesized that Ache men would not show age‐related variation in testosterone circadian rhythms. Diurnal rhythmicity in testosterone within and between Ache men in association with age (n = 52; age range, 18–64) was therefore examined. A significant negative association was evident between the ratio of morning and evening salivary testosterone and age (r = ?0.28, P = 0.04). Men in their third decade of life exhibited significant diurnal variation (P = 0.0003), whereas older and younger age classes did not. Men between the ages of 30 and 39 also exhibited a higher AM:PM testosterone ratio compared to 40–49 and 50< year old men (P = 0.002, 0.006). Overall, declines in testosterone with aging may not be universal among human males, however, within‐individual analyses of diurnal variation capture age‐related contrasts in daily testosterone fluctuations. Circadian rhythmicity differs with age among the Ache and may be a common aspect of reproductive senescence among men regardless of ecological context. Am. J. Hum. Biol., 2010. © 2009 Wiley‐Liss, Inc.     

不同负荷运动对雄性肥胖模型小鼠性激素和精子质量的影响

BACKGROUND: Overweight and obesity can lead to a disorder of sex hormone in men. The increase in female hormone levels may inhibit the synthesis and secretion of male hormone, increase fat accumulation and form a vicious circle. Exercise can effectively reduce body fat. OBJECTIVE: To investigate the effects of different exercise loads on sex hormone and the quality of sperm in obese male mice. METHODS: Weanling male C57BL/6J mice were divided into normal control group and obesity group. Mice in the obesity group were given high fat diet for 10 weeks to establish mouse model of obesity. The amount of food and water was recorded daily. Body weight was weighed once every week. After model induction, models were assigned to obesity moderate load exercise group and obesity high load exercise group. These models did exercises for 8 weeks. Body length was measured. Body weight, abdominal fat, testis, epididymis and seminal vesicle were weighed. Sperm activity and motility were observed by the sperm counting method in the epididymis tail. Enzyme linked immunosorbent assay was used to measure serum progesterone, follicle stimulating hormone, testosterone and estradiol.  RESULTS AND CONCLUSION: Compared with the normal control group, body weight, abdominal fat weight, and lee’s index were increased (P < 0.01); the coefficient of testis and seminal vesicle were significantly decreased (P < 0.01); serum levels of luteinizing hormone, follicle stimulating hormone and testosterone were significantly decreased and estradiol level was significantly increased (P < 0.05); sperm count and activity were significantly decreased in the obesity group (P < 0.01). Compared with the obesity group, body weight, abdominal fat weight and lee’s index were significantly decreased (P < 0.05 or P < 0.01); the coefficient of testis and seminal vesicle were significantly increased in the obesity moderate load exercise group and obesity high load exercise group (P < 0.05 or P < 0.01). Serum luteinizing hormone, follicle stimulating hormone and testosterone levels were significantly increased (P < 0.05 or P < 0.01); estradiol levels were significantly decreased (P < 0.05); sperm count and activity were significantly increased (P < 0.01, P < 0.05) in the obesity moderate load exercise group. Compared with the obesity moderate load exercise group, abdominal fat weight and lee’s index were significantly reduced (P < 0.05); serum luteinizing hormone, follicle stimulating hormone, testosterone, sperm count and activity were decreased in the obesity high load exercise group (P < 0.01). These results indicate that long-term high fat diet leads to early obesity in males, inhibits the development of the reproductive gland and reproductive organs, and causes the decrease of the level of male hormone and sperm quality. Long-term moderate load exercise effectively reduces body fat, improves the inhibitory effect on male reproductive organs and glands, and relieves the negative effect of obesity on reproductive function. The effect of long-term large load exercise on reducing body fat is better than medium load exercise, but it has little effect on improving the level of male hormone in obese mice or on relieving the negative effect of obesity on reproductive function, even has a tendency to aggravate.       

Impact of acute sleep restriction on cortisol and leptin levels in young women

Sleep restriction alters hormone patterns and appetite in men, but less is known about effects on women. We assessed effects of overnight sleep restriction on cortisol and leptin levels and on appetite in young women. Participants' baseline sleep duration and eating habits were monitored for a week before the study. Salivary cortisol and leptin were sampled from fifteen healthy women (aged 18-25) during two consecutive days: first after a 10 h overnight sleep opportunity (Baseline day) and then after a night including only 3 h sleep (Post sleep-restriction day). Participants also completed appetite questionnaires on both days. Sleep restriction significantly reduced morning cortisol levels (p = 0.02), elevated morning leptin levels (p = 0.04), elevated afternoon/evening cortisol area under the curve values (p = 0.008), and slowed the decline in cortisol concentration during the day (p = 0.04). Hunger and craving scores did not differ significantly between days. A single night of restricted sleep affected cortisol rhythms and morning leptin levels in young women.     

Salivary cortisol, APOE-ε4 allele and cognitive decline in a prospective study of older persons

Objective

We determined whether salivary cortisol levels were associated with cognitive decline at follow-up in older persons and whether this association was modified by the APOE-ε4 allele.

Methods

Within the Longitudinal Aging Study Amsterdam (LASA), a population-based prospective cohort study, 911 persons (74.5 ± 7.2 years, 46.4% male) collected salivary cortisol in the morning and late in the evening. At baseline and after 4 years of follow-up, global cognitive functioning, verbal memory performance, and processing speed were assessed. The longitudinal associations between cortisol measures and cognitive decline were estimated using linear mixed models, adjusted for potential confounders and the modifying role of the APOE-ε4 allele was examined.

Results

Lower morning cortisol levels, higher evening cortisol levels, and flattened diurnal variability of cortisol levels were associated with increased risk for memory decline in APOE-ε4 carriers but not in non-carriers.

Conclusion

Our findings suggest that in this older non-demented population APOE-ε4 carriers may be more vulnerable to the potential detrimental effect of hypothalamic-pituitary-adrenal axis dysfunction on verbal memory performance.     

Reproducibility of low resting testosterone concentrations in endurance trained men

Previous reports indicate endurance trained (ET) men have resting tstosterone concentrations without any significant increases in their luteinizing hormone (LH) concentrations. The purpose of this study was to examine the reproducibility of these resting hormonal findings in ET men. Resting blood samples were collected at three separate trials (2 weeks apart) in groups of ET men (n = 15) and age-matched, untrained (UT n = 13) men. Blood specimens were analyzed for total testosterone, LH, cortisol and prolactin. Results indicated that testosterone was significantly (p < 0.01) lower in ET than UT at each of the three trials. LH, cortisol, and prolactin were not different (p > 0.05) between the groups at any trial. These results confirm earlier findings reported for ET men. Furthermore, the results indicate the resting reproductive hormonal status (i.e., low testosterone) of ET men is reproducible and does not appear to be an artifact of the timing of the blood sampling methodology used.     

Reconsidering the role of sex hormones in psychopathy development: Estrogen and psychopathy among male justice‐involved youth

Prominent theory suggests that factor one psychopathic traits may develop from increased input from hormones in the hypothalamic pituitary gonadal axis (HPG; i.e., testosterone) and decreased input from the hypothalamic pituitary adrenal axis (HPA; i.e., cortisol). Although there are extensive findings connecting low cortisol to psychopathy, less support has emerged for high levels of testosterone. This study examined whether incorporating the HPG hormone, estradiol, into this model would reveal relationships in line with theory: high levels of estradiol and testosterone in combination with low levels of cortisol would inform psychopathic traits. Baseline and reactive hormone levels were measured and compared to Psychopathy Checklist‐Youth Version (PCL‐YV) interviews among 66 male justice‐involved youth (M age = 15.73) in a Southeastern juvenile detention center. The primary findings of this study were relationships between interacting HPA and HPG axis hormones with facet one and facet two psychopathic traits. Specifically, psychopathy total scores, interpersonal traits, and affective traits related to estradiol and testosterone reactivity, in that psychopathy scores were more likely with decreases in hormone reactivity (i.e., change in hormone level) following a stressor. Moreover, affective traits related to reactivity in all three hormones. These findings support inclusion of estradiol in neurobiological models of psychopathy and consideration of the individual components of psychopathy. This study adds to the growing body of research supporting interactions between variations in functioning of the HPA and HPG axes in relation to psychopathy.     

Relationship between salivary cortisol and depression in adolescent survivors of a major natural disaster

The purpose of this study was to determine the utility of salivary cortisol levels for screening mental states such as depression in adolescents following a natural disaster. We examined the relationship of salivary cortisol levels in adolescent survivors of the 2011 Tohoku Earthquake with the depression subscale of the 28-item General Health Questionnaire (GHQ). Subjects were 63 adolescent survivors (age = 14.29 years ± 0.51) who were administered the GHQ and provided saliva samples thrice daily (morning, afternoon and evening) over the course of 3 days. Based on the GHQ-depression subscores, subjects were divided into low and high depression groups. About 22 % of the subjects were classified into the high symptom group. When data collected over 3 days were used, a significant difference was observed between the two groups in the salivary cortisol levels at the evening time point as well the ratio of the morning/evening levels (p < 0.05). Analyzed by means of receiver-operating characteristic curves, the morning/evening ratios showed a good power in discriminating between subjects with and without depressive symptoms. Our study suggests that repeated measurement of salivary cortisol levels over 3 days has utility in screening for depressive states in adolescents following a natural disaster.     

The relationship between long-term job strain and morning and evening saliva cortisol secretion among white-collar workers

The objective of this study was to assess long-term job strain impact on morning and evening salivary cortisol secretion. In all 77 white-collar workers (31% women; sample mean age, 42 years at baseline) volunteered to sample morning (immediately after waking up) and evening (10 p.m.) salivary cortisol for 7 consecutive days. By median split on aggregated self-reported isostrain from three consecutive questionnaires distributed in a period of approximately 3.5 years the participants were classified into a high or low long-term isostrain condition. Regardless of strain condition, there was a significant reduction in morning salivary cortisol secretion from the working week to the weekend, whereas evening salivary cortisol secretion showed no significant variation during the week. Although chronic isostrain did not affect the morning saliva cortisol measures, evening cortisol secretion was significantly elevated in the chronic high isostrain group throughout the whole week. The elevated evening cortisol measures associated with chronic high strain are concordant with the findings in other studies on long-term strain.     

Salivary testosterone levels in males from the Ituri Forest of Zaïre

Morning and evening testosterone levels were measured in the saliva of Efe pygmies (N = 11) and Lese villagers (N = 18) living in the Ituri Forest of northeast Zaïre and compared with levels in Boston controls (N = 10). With one exception, levels in the individual Zaïrois subjects fall within the normal ranges reported for Western clinical populations. Daily variation in the Zaïrois subjects (a.m./p.m. ratio = 1.32 for Efe, 1.22 for Lese) is also comparable to both the Boston controls (1.61) and values reported by other researchers for Western subjects. Average morning levels for the Zairois subjects (420 pmol/liter for Efe, 341 pmol/liter for Lese), however, fall significantly below the average for the Boston subjects (589 pmol/liter; Efe, P <0.05; Lese, P <0.01). A correlation between morning testosterone level and height is observed for the Lese sample (r=0.76, P <0.005). Similar correlations have not been reported for Western subjects. Possible roles of acute and chronic environmental conditions in generating these observations are noted. This study demonstrates the potential utility of salivary steroid assays for investigating questions related to male gonadal function under field conditions.     

A prospective study of diurnal cortisol responses to the social experience of school transition in four-year-old children: anticipation, exposure, and adaptation

This study examined psychosocial influences on hypothalamic-pituitary-adrenal axis activity in 105 4-year-old children transitioning to primary school. Measuring before, during, and after school transition over a period of up to 12 months, salivary cortisol was assessed on awakening and early evening. Parents reported child temperament and teachers recorded adaptive behavior. Whilst cortisol at awakening and early evening increased from baseline to school transition, effects were not significant. A significant decrease occurred between transition and follow-up and from baseline to follow-up for both awakening and evening cortisol. Poorer effortful control was associated with high morning and steeper diurnal slope of cortisol at transition whilst surgency/extroversion was associated individually with greater morning and evening cortisol at transition and adaptation. Greater increase in internalizing social isolation during the first 6 months of school in more surgent/extrovert children predicted higher morning and evening cortisol at follow-up. This study is the first to explore these adaptive relationships over a 12-month period and supports social isolation over time as a key element in developmental endocrine activation.     

The cortisol awakening response (CAR) in 2- to 4-year-old children: effects of acute nighttime sleep restriction, wake time, and daytime napping

The cortisol awakening response (CAR) is presumed critically important for healthy adaptation. The current literature, however, is hampered by systematic measurement difficulties relative to awakening, especially with young children. While reports suggest the CAR is smaller in children than adults, well‐controlled research in early childhood is scarce. We examined whether robust CARs exist in 2‐ to 4‐year‐old children and if sleep restriction, wake timing, and napping influence the CAR (n = 7). During a 25‐day in‐home protocol, researchers collected four salivary cortisol samples (0, 15, 30, 45 min post‐wake) following five polysomnographic sleep recordings on nonconsecutive days after 4 hr (morning nap), 7 hr (afternoon nap), 10 hr (evening nap), 13 hr (baseline night), and 16 hr (sleep restriction night) of wakefulness (20 samples/child). The CAR was robust after nighttime sleep, diminished after sleep restriction, and smaller but distinct after morning and afternoon (not evening) naps. Cortisol remained elevated 45 min after morning and afternoon naps. © 2011 Wiley Periodicals, Inc. Dev Psychobiol 54:412–422, 2012.     

Morningness-eveningness and early-morning salivary cortisol levels.

The purposes of this exploratory study were: (1) to describe a 2-h segment of the early-morning salivary cortisol levels of morning (M) and evening (E) types of healthy, day-active adults on one morning; and (2) to compare selected demographic and sleep characteristics. The sample consisted of 20 subjects, aged 23-39 years, 10 of each type. Measures included: morningness-eveningness questionnaire score, demographic information, self-report sleep characteristics, and self-report of well-being. Beginning with time of arising, seven salivary samples were collected at approximately 20-min intervals. Among the sleep variables, bedtime (p = 0.005), time of mid-sleep (p = 0.002), and arising time (p = 0.043) were later in the E group as compared to the M group. Six M and one E subject awoke spontaneously on the morning of sampling without an awakening aid (p = 0.018). Even though total hours of sleep were comparable between groups, E subjects reported feeling less rested in the morning (p = 0.019). Although mean M group salivary cortisol levels were greater than mean E group levels for each sampling time, there were no significant group differences. Eight M subjects reached a sampling period salivary cortisol peak by 50 min after arising, contrasted with six E subjects who reached their peak at that time. These preliminary findings suggest that E types demonstrate lower morning arousal and a delay in their early-morning peak of salivary cortisol relative to M types. Further study is needed to explore the relationship between M and E types, their sleep-wake patterns, and cortisol secretion patterns.     

Neuromuscular and hormonal responses in elite athletes to two successive strength training sessions in one day

Summary Acute neuromuscular and endocrine adaptations to weight-lifting were investigated during two successive high intensity training sessions in the same day. Both the morning (I) (from 9.00 to 11.00 hours) and the afternoon (II) (from 15.00 hours to 17.00 hours) training sessions resulted in decreases in maximal isometric strength (p<0.01 and <0.05), shifts (worsening) in the force-time curve in the absolute scale (p<0.05 and ns.) and in decreases in the maximal integrated EMG (p<0.01 and <0.05) of the selected leg extensor muscles. Increases in serum total (p<0.05) and free testosterone (p<0.01) and in cortisol (p<0.01) concentrations were found during training session II. These were followed by decreases (p<0.001 andp<0.01 and ns.) in the levels of these hormones one hour after the termination of the session. The responses during the morning training session were different with regard to the decreases in serum total testosterone (p<0.05), free testosterone (ns.) and cortisol (p<0.05). Only slight changes were observed in the levels of luteinizing hormone and sex hormone-binding globulin during the training sessions. Increases (p<0.01) took place in somatotropin during both training sessions. The present findings suggest that high intensity strengthening exercises may result in acute adaptive responses in both the neuromuscular and endocrine systems. The diurnal variations may, however, partly mask the exercise-induced acute endocrinological adaptations in the morning. Recording of muscle activation and muscle strength and analysis of certain serum hormone concentrations with sufficient frequency during the training process may be useful in optimizing and controlling the contents of individual training sessions and the full training program.     

Hypothalamic-pituitary-adrenal and -gonadal axis function after exercise in sedentary and endurance trained elderly males

The aim of this study was to investigate hypothalamic-pituitary-adrenal (HPAA) and -gonadal (HPGA) axis responses to post-exercise (30?min at 65% V˙O_2max) combined corticotrophin, luteinizing hormone and thyrotrophin releasing hormone challenge (0.7 μg/kg body mass) in elderly distance runners (DR; age: 68.9?±?4.2 year) and sedentary individuals (SI; age: 69.1?±?2.6 year). Plasma cortisol, growth hormone, prolactin, luteinizing hormone, follicle stimulating hormone and total testosterone (T) concentrations pre- and post-exercise as well as in response to stimulation did not differ between DR and SI. Plasma adrenocorticotropic hormone returned to pre-exercise level in DR 60?min and in SI 90?min post-stimulation. Free T was lower in DR at all time points. Our results do not support the notion of altered releasing hormone-stimulable HPAA and HPGA synthesis-secretion capacity in elderly males after endurance training.     

Decreased hypothalamic gonadotropin-releasing hormone secretion in male marathon runners

Hypogonadotropic hypogonadism due to a deficiency in hypothalamic gonadotropin-releasing hormone is common in female athletes ("hypothalamic amenorrhea"). It is not known, however, whether a similar phenomenon occurs in male athletes. We investigated the integrity of the hypothalamic-pituitary-gonadal axis in six highly trained male marathon runners (who were running 125 to 200 km per week). The mean (+/- SEM) frequency of spontaneous luteinizing hormone pulses was diminished in the runners, as compared with healthy controls (2.2 +/- 0.48 vs. 3.6 +/- 0.24 pulses per eight hours, P less than 0.05). The amplitude of the pulses was also low in the runners (0.9 +/- 0.24 vs. 1.6 +/- 0.15 mlU per milliliter; P less than 0.05), and the responses of luteinizing hormone to gradually increasing doses of exogenous gonadotropin-releasing hormone were decreased. Plasma testosterone levels were similar in the two groups and increased equally in response to an intramuscular injection of 2000 units of human chorionic gonadotropin. During short-term intense physical exercise (a treadmill run at 72 percent of maximal oxygen consumption for two hours), the plasma gonadotropin levels in the athletes remained stable, but significant elevations in plasma levels of cortisol, prolactin, and testosterone occurred. We conclude that highly trained male athletes, like their female counterparts, may have a deficiency of hypothalamic gonadotropin-releasing hormone. This condition may be caused by the prolonged, repetitive elevations of gonadal steroids and other hormones known to suppress gonadotropin-releasing hormone secretion that are elicited by their daily exercise.     

Genetic testing facilitates prepubertal diagnosis of congenital hypogonadotropic hypogonadism

Neonatal micropenis and cryptorchidism raise the suspicion of congenital hypogonadotropic hypogonadism (CHH), a rare genetic disorder caused by gonadotropin‐releasing hormone deficiency. Low plasma testosterone levels and low gonadotropins during minipuberty provide a clinical diagnostic clue, yet these tests are seldomly performed in general practice. We report a male neonate with no family history of reproductive disorders who was born with micropenis and cryptorchidism. Hormonal testing at age 2.5 months showed low testosterone (0.3 nmol/L) and undetectable gonadotropins (luteinizing hormone and follicle‐stimulating hormone both <0.5 U/L), suggestive of CHH. Genetic testing identified a de novo, heterozygous mutation in fibroblast growth factor receptor 1 (FGFR1 p.L630P). L630 resides on the ATP binding cleft of the FGFR1 tyrosine kinase domain, and L630P is predicted to cause a complete loss of receptor function. Cell‐based assays confirmed that L630P abolishes FGF8 signaling activity. Identification of a loss‐of‐function de novo FGFR1 mutation in this patient confirms the diagnosis of CHH, allowing for a timely hormonal treatment to induce pubertal development. Therefore, genetic testing can complement clinical and hormonal assessment for a timely diagnosis of CHH in childhood.     

Relationship between obstructive sleep apnea and diurnal leptin rhythms

STUDY OBJECTIVES: Several studies have reported an association between obstructive sleep apnea and leptin, a hormone that influences satiety and body weight. We evaluated the relationship of leptin levels and the overnight change in levels with sleep apnea. DESIGN: Cross-sectional analysis of data from a prospective cohort study. SETTING: Case Western Reserve University General Clinical Research Center. PATIENTS OR PARTICIPANTS: A total of 138 individuals participating in the Cleveland Family Study--59% women, 45% African-American, with mean apnea-hypopnea index (AHI) of 6.9 (range 0-106)--were studied. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Serum leptin was measured at 10:00 pm to 11:00 pm and at 7:00 am to 8:00 am. Leptin levels in both the morning and evening were positively correlated with apnea-hypopnea index (AHI) in age-, sex-, and race-adjusted analyses (P < .0001) but not after additional adjustment for body mass index. The evening/morning leptin ratio, however, was associated with AHI independent of age, sex, race, body mass index, and waist-hip ratio (P = .03). Conversely, AHI was an independent predictor of the leptin ratio (P = .001) and more predictive than arousal index, oxygenation indices, time asleep, or sleep-stage distribution. An AHI > 15 was associated with a 23% increase in leptin ratio. CONCLUSIONS: These findings suggest that sleep apnea may suppress secretion of leptin in the morning. Alternatively, the relative elevation in evening leptin may influence apnea pathogenesis.     

Suppression of hypothalamic-pituitary-adrenal axis activity with inhaled flunisolide and fluticasone propionate in adult asthma patients.

BACKGROUND: Suppression of the hypothalamic-pituitary-adrenal (HPA) axis, a potential systemic effect of inhaled corticosteroid therapy, can be quantified by monitoring serum, urinary, and salivary cortisol levels. OBJECTIVES: 1) Compare the effects on HPA axis of the inhaled corticosteroids flunisolide and fluticasone propionate versus placebo and oral prednisone. 2) Estimate dose-potency ratio for HPA-axis suppression. METHODS: Multicenter, randomized, placebo-controlled, open-label, 21-day trial. Active regimens were flunisolide 500 and 1,000 microg, twice daily; fluticasone propionate 110, 220, 330, and 440 microg, twice daily; and prednisone, 7.5 mg daily. Enrolled patients were nonsmokers, 18 to 50 years of age, with persistent mild-to-moderate asthma and had not used oral, nasal, or inhaled corticosteroids for 6 months before study. Main outcome measures were area under serum cortisol concentration curve for 22 hours (AUC(0-22h)); 24-hour urinary cortisol level; and 8 AM salivary cortisol level. RESULTS: One hundred fifty-three patients were randomly assigned to active treatment or placebo; 125 patients completed the study and were at least 80% compliant with their regimens. Both fluticasone propionate and flunisolide caused dose-dependent suppression of HPA axis, which was statistically greater for fluticasone propionate (P = 0.0003). Dose-potency ratio showed 4.4 times more serum-cortisol suppression/microgram increase in dose with fluticasone propionate than with flunisolide. Diurnal pattern of serum cortisol suppression was persistent with fluticasone propionate and "remitting" with flunisolide. Salivary and urinary cortisol data were qualitatively similar to serum cortisol results. CONCLUSIONS: Fluticasone caused significantly more suppression of HPA axis than flunisolide. Flunisolide may provide a safe option for patients with asthma requiring long-term inhaled corticosteroid therapy.     

Digit ratio (2D:4D) as an indicator of body size,testosterone concentration and number of children in human males

Objectives: The 2nd to 4th digit ratio (2D:4D) is thought to reflect exposure to androgens during foetal development. This study examined the relationship between low (more masculine) and high (more feminine) 2D:4D and body size at different stages of the life course, adult testosterone levels and number of children among males.

Methods: Five hundred and fifty-eight men from rural Poland at the Mogielica Human Ecology Study Site participated in this study. Life history data and anthropometric measurements were collected. Salivary morning and evening testosterone levels among 110 men from the same population were measured.

Results: Low 2D:4D was related to higher birth weight (p?=?0.04), higher birth length (p?=?0.01), higher body mass during childhood and adolescence (p?=?0.01), higher BMI (borderline significance, p?=?0.06), higher number of children among fathers (p?=?0.04) and higher testosterone levels during adulthood (p?=?0.04).

Conclusions: This study shows, for the first time in a single population, that digit ratio is related to sub-adult body size at different stages of the life course, adult testosterone levels and number of children. The observed results suggest that digit ratio might be a valuable predictor of male body size and reproductive characteristics.